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Wednesday, November 30, 2016

Yet another circumcision botch from my Facebook news feed. These are way more common than circumcision advocates would like others to believe.

This one is unknown; the names have been blotted out for privacy.

What else can I say?

The foreskin is not a birth defect. Neither is it a congenital
deformity or genetic anomaly akin to a 6th finger or a cleft. Neither is
it a medical condition like a ruptured appendix or diseased gall
bladder. Neither is it a dead part of the body, like the umbilical
cord, hair, or fingernails.

The foreskin is not "extra skin." The foreskin is normal, natural,
healthy, functioning tissue, present in all males at birth; it is as
intrinsic to male genitalia as labia are to female genitalia.

Unless there is a medical or clinical indication, the circumcision of a
healthy, non-consenting individuals is a deliberate wound; it is the
destruction of normal, healthy tissue, the permanent disfigurement
of normal, healthy organs, and by very definition, infant genital
mutilation, child abuse, and a violation of the most basic of human rights.

Without medical or clinical indication, doctors have absolutely no
business performing surgery in healthy, non-consenting individuals, much
less be eliciting any kind of "decision" from parents.

Genital mutilation, whether it be wrapped in culture, religion or “research” is still genital mutilation.

It is mistaken, the belief that the right amount of “science” can be
used to legitimize the deliberate violation of basic human rights.

The fact is 70% of the men in the world have anatomically correct penises, and there simply isn't an epidemic of "problems."
The highest prevalence of STDs including HIV can be observed in the US, where 80% of males are already circumcised from birth.

Only about 1% of males will ever need to be circumcised.

STDs are already better prevented with sex education and condoms.

The circumcision of healthy male infants is not medically necessary.
The risks of male infant circumcision include infection, partial or full ablation, hemorrhage, and even death.

Thursday, November 17, 2016

Of course for intactivists, high on the priority list for candidate eligibility is where they stand regarding circumcision, particularly the forced circumcision of healthy, non-consenting minors.

For a while, it was looking like Bernie Sanders was going to be the democratic nominee. That is until things got hairy in different states in regards to counting people's votes.

Anomalies marred the voting process all over the country, including the sudden change in affiliation or the outright disqualification of some voters in New York, the sudden reduction of polling places in Puerto Rico and Arizona causing long waiting lines and some people not being able to vote in time as a result, the convention mayhem that ensued in Nevada, not to mention the coin tosses that ensued in Iowa, and Hillary Clinton calling victory in California before all the votes could even be counted.

Additionally, Bernie was pro-universal health care, which for many intactivists, translated to male infant circumcision being defunded in all 50 states, as universal health care would be expected to pay for only medically necessary treatment and/or procedures, something which male infant circumcision is not.

If the following account is to be believed, Bernie Sanders actually made a statement on the subject of male infant circumcision. The following account was first published on Facebook. I have confirmed the source and the person has allowed me to reproduce it here under the condition of anonymity:

"Hi! I'm a
precinct captain for my local Bernie Sanders office. I met him the day
our office opened and talked briefly with him. I asked him how he felt
about circumcision and he said, "I feel we should be following the lead
of more medically advanced nations when it comes to any and all medical
procedures." It was said directly to me. There were hundreds of people
around. Considering more medically advanced countries do not cut infant
boys, I took it as a good thing. He seemed a little taken aback with the
question, answered it, and walked off. There was an older guy behind
me. He said he was shocked I would ask such a personal question, shook
his head, and walked away."
~A friend in the Midwest, Iowa, January 18, 2016

Bernie was a progressive who spoke to the issues of many, and he wasn't looking to further the interest of any one sex, race or religious creed. It was the ideal win-win situation; many intactivists really wanted Bernie Sanders to win.

Intactivists were split into two camps; the side for which circumcision was issue number one, and the side for which circumcision would have to be put on the back burner because they would rather see Hillary Clinton as president over Donald Trump. Knowing Clinton's background with circumcision, some intactivists decided to vote for Jill Stein, or simply Donald Trump because they didn't want to see a president who was directly involved in the ongoing promotion of circumcision as HIV prevention in Africa rise to power.

It was a tough split. For a lot of intactivists, circumcision was not their sole issue; for some intactivists, preserving women's and LGBT rights, and preventing an unabashedly racist president were issues that were far more important than stopping the promotion of circumcision with pseudo-medical lies. Still others did not want a president who was wedded to the banks and corporations on Wall Street, and who had a history of promoting fracking and who was remaining silent on the ongoing Silent Rock oil pipeline crisis.

Between a president who wants to circumcise Africa, possibly the world, with financial interests in maintaining the status quo, and who seems intent on initiating World War 3 with Iran and/or Russia, and a president who disparages women, minorities and has ties to white supremacist groups, not to mention his inexperience in politics and his reputation as a failed businessman who evaded taxes, it was a really tough call.

Jill Stein had some qualities that made her very attractive to intactivists. For the most part, she echoed Bernie Sanders' progressive views. Like Bernie, she was also Jewish but she didn't wear her religion on her sleeve. The double-whammy was that she also happened to be a woman, who, unlike Hillary, wasn't tying her sex to her presidential campaign.

Something else that made Stein very attractive to intactivists was the allegation that she supposedly endorsed Intact America. The Green Party of New Jersey posted on their Facebook website (last accessed 11/18/2016) that she had given her endorsement back in 2012. A Jewish person taking a stand against the forced genital cutting of all children would be an attractive presidential candidate indeed.

But now it's all over, our next president has been decided, and while some intactivists dread the decision, and are browbeating all of those who didn't vote for Clinton, others are sighing a sigh of relief. At least with Clinton gone, they say, there might be less promotion of circumcision going on in Africa, and children in the US will be a little more safe.

But will the situation improve under Trump?

I'm not sure how many intactivists have been paying attention, but it looks as if Trump may have some incentive to continue promoting circumcision under the guise of medicine

According to Ezra Levant from "The Rebel," all of Donald Trump's children are either married to, or marrying Jewish people. Ivanka is married to Jared Kushner, who is Jewish; she converted to Judaism and actually took a Jewish name. Her kids, Trump's grandchildren would also be Jewish.

Donald Jr. is married to Vanessa Haydon, Eric Trump is married to Lara Yunaska, and Tiffany Trump is dating Ross Mechanic, all of whom are Jewish.

The very Trump Organization has people in high executive positions who are Jewish. Executive Vice Presidents Michael D. Cohen and Jason Greenblatt, along with Chief Financial Officer Alan Weisselberg are all Jewish.

There were Jewish people working within Trump's presidential campaign; his speech writer and opening speaker at many of his rallies, Stephen Miller, his Communications Coordinator, Michael Abboud, his Finance Chair, Steve Mnuchin, are all Jewish.

But given the fact that Jews who oppose male infant circumcision are a minority, I'd say there's a very good chance that Trump will have plenty of incentive to continue promoting circumcision as medicine in Africa via PEPFAR.

Or, who knows.

Trump may decide PEPFAR is a "yuge" waste of money and an international aid folly the US can do without.

Monday, October 24, 2016

It seems that how many men they hornswoggle into getting circumcised, and how many parents they convince to allow doctors to circumcise their children, continues to be the new measure of "success" in reducing AIDS transmission at the WHO/UNAIDS.

Within the past few days, UNAIDS has published not one, not two, but three articles regarding so-called "VMMC" (the catchy acronym that stands for "Voluntary Male Medical Circumcision") on their website.

None of them question the mantra that "circumcision reduces the risk of HIV transmission by 60%" and what it's based on; they just tout it as given fact.

All of them sweep the reader past the fact that, in all actuality, scientists and researchers don't know that circumcision reduces the transmission of HIV at all, let alone by the fabled 60%.

But even accepting the claim that "circumcision prevents HIV transmission by 60%" at face value, no one seems to be concerned that there would still be that 40% that men and women have to worry about; circumcised men still run the risk of acquiring HIV.

So ineffective would circumcision be at preventing HIV transmission, that HIV workers must stress to circumcised men and their partners, that circumcision is not protection, and that they still have to use condoms.

Bringing into question the use of promoting circumcision as HIV prevention in the first place.

The Underlying Theme: The Better Mousetrap
After reading each of the articles, I noticed a connecting underlying theme; and that's finding a better way to circumcise more males in a shorter time.

It's a recurring theme; actually, finding more men to circumcise is a problem HIV/AIDS organizations face every year.

Every year, WHO/UNAIDS sends a double-message. On the one hand, they want to let on on how successful their programs are. "Those foreskins are flying," Robert Bailey once assured in the New York Times. On the other hand, their strongest message is that "We still need your help! Don't stop sending us your money!"

Well, not exactly in those words, but you know, just about.

When the "mass circumcision programs" first began, there was an initial surge of men lining up to get circumcised at medical facilities. Initially, circumcision programs were able to claim success, but that has pretty much died down.

The number of men coming forward for circumcision, and parents allowing their children to be circumcised has since plateaued, and now circumcision promoters are at their wit's end trying to encourage more men to get circumcised.

In Swaziland, the "Soka Uncobe" (or "Circumcise and Conquer") campaign was launched with the intention of circumcising 80% of the male Swazi population (that's 200,000 men), but the program ended in failure, as after four years, the program was able to convince only 20% (roughly 34,000 men) of the population to undergo circumcision.

Programs in other countries are also facing the same failure to circumcise the number of men they want, such as in Zimbabwe, Botswana, Zambia and Kenya.

It is my suspicion that the men who initially did go in to get circumcised, were men who belonged to tribes and cultures where circumcision is already a rite of passage, and who were going to be circumcised anyway. (WHO/UNAIDS doesn't want to talk about this, but circumcision is already quite wide-spread in Africa. It is not too difficult to find men who want to get circumcised, because circumcision is already a rite of passage in many tribes and Muslim communities.)

Perhaps there were a few gullible men here and there who actually bought into the circumcision/HIV propaganda, but on the whole, those who went in were probably only men who couldn't care less about the potential HIV reduction, who said whatever they had to in order to cash in on a free and "safe" circumcision. All of the men who were going to get circumcised have gotten circumcised, so there's no one left, until new tribe or Muslim initiates come of age.

It seems circumcision promoters can't stop asking themselves, "What could be the problem? What has gone wrong? Why aren't men breaking down the doors to have part of their penis cut off?"

"Circumcise or bust!" seems to be the motto.

"We need to do whatever it takes to get as many men and boys circumcised."

And this, I believe, is what's wrong with HIV programs in Africa today. Somehow, progress on the HIV front has come to be measured, not by how much HIV infection has decreased in time, but by how prolific the practice of circumcision has become.

This time, they got it. They really got it.
WHO/UNAIDS has published the following report; "Effective HIV prevention and a gateway to improved adolescent boys & men’s health in eastern and southern Africa by 2021", which would be better labeled "Circumcising More Boys and Men."

The report says that the annual number of "VMMC" needs to increase to 5 million per year. According to the report, the following elements must be achieved:

Promoting VMMC as part of a wider package of sexual and reproductive services for men and boys, including comprehensive sexuality education, the use of condoms and communication around gender norms, including positive notions of masculinity.

Using new integrated service delivery models.

Using approaches that are tailored for various age groups and locations.

Increasing domestic funding to ensure the sustainability of VMM[C] and expanding sexual and reproductive health services for men and boys.

Developing new approaches for adolescent and early infant circumcision.

Breaking down myths and misconceptions about circumcision.

To me, these read as:

Make circumcision as a condition for sex education, condoms, and manhood (e.g. social stigma)

Make "VMMC" a condition for receiving funds for sex and reproductive health services for men and boys

Get 'em while they're young, target the youth and find ways to convince parents to have their children circumcised (WHERE'S THE "VOLUNTARY" IN THAT?)
Brainwashing people into accepting circumcision by creating myths and misconceptions

In the second article published by UNAIDS, the Bill and Melinda Gates foundation appears to be investing in "research" on how to brainwash the African populace to uptake circumcision more effectively.

Reads the article:

"...while service delivery for VMMC has improved, uptake has stalled. In response, the Bill & Melinda Gates Foundation funded Ipsos Healthcare, a market research company, to investigate how to better understand behavioural and psychographic characteristics of men and boys and the barriers and facilitators within their journey from awareness of the VMMC to uptake."

Circumcision or bust. In other words, they want to see what makes them tick, what buttons they have to push, such that they accept circumcision.

Second, this endorsement is already resulting in the violation of basic human rights. Promoting circumcision as HIV prevention is giving circumcising tribes the green light to forcibly circumcise members of their tribes, and even members of rival tribes:

The fact is that circumcision has become a prerequisite in receiving fund from donors. HIV organizations are being given quotas of circumcised males that they must meet in order to receive funds. This is resulting in very underhanded activity.

Again, is it not obvious that the "voluntary" part of the catchy "Voluntary Male Medical Circumcision" acronym is nothing more than vestigial?

On the bright side, perhaps the UNAIDS articles are good news for the intactivist movement. Perhaps they are a sign of circumcision advocates' despair and frustration, because their plans to circumcise Africa aren't going as swimmingly as they had originally planned.

Perhaps the need to underline that they're struggling to find better ways to spread circumcision, is indicative of the fact that Africans aren't buying the lie that circumcision has anything to do with HIV prevention so easily.

Africans Aren't Stupid
It doesn't take a rocket scientist to figure out why circumcision promoters are having trouble achieving their quotas. You don't need "studies" and "surveys" to figure out why.

Men simply don't see the value of getting circumcised, to undergo a painful, life-altering, permanent surgical alteration, which will permanently change the appearance and mechanics of their penises, if it means they only get "partial protection." Being told that "circumcision reduces HIV transmission by 60%" isn't all that impressive if it means that they still have to wear condoms.

Married men simply don't see the value of getting circumcised if they are faithful to their wives, and therefore not at risk for sexually transmitted HIV.

Women certainly don't want to be made to feel like their man is going out on them with other women. They want to be able to trust their partners with fidelity. So why would they encourage their men to go get circumcised? What can having their husbands go get circumcised mean, other than that they are expecting them to be unfaithful?

That the people up at HIV organizations think that they can actually get away with promoting circumcision the way they do can mean only one of to things; either HIV organizations are dense and stupid, or they believe the African public is.

From an outside, non-African perspective, I simply can't believe the bullshit that western HIV organizations are attempting to feed the people of Africa. Looking at what's going on in Africa, I'm simply insulted as an intact male.

As an intact man, I am expected to believe that, a) circumcision "reduces the likelihood of HIV transmission by 60% (from female to male)," and b) that I still have to wear condoms.

I ask, why in the world would any man in the right mind choose to have part of his penis removed, if it meant that one still had to wear condoms?

"60% protetion."

Just what does that mean?

Imagine parachutes that worked only 60% of the time, and malfunctioned the remaining 40%.

For no discernible rhyme or reason.

Who in the right mind would want parachutes like that?Is it any wonder HIV organizations are having trouble convincing the masses to accept circumcision as their lord and saviour?

I ask, if I'm not convinced by this argument, why would I expect any other man to be? Let alone the men in Africa?

No intact man in the right mind could ever go for this. Men who are fully informed, men who have been made aware of all the facts simply cannot see any value in undergoing circumcision, and can clearly see that it is complete madness that organizations are spending millions in funds trying to convince other men to part with their foreskins for only "partial protection." If you went around pushing this nonsense in Europe, people would laugh in your face. They're pushing this shit in Africa because they think Africans are gullible idiots.

The only people who see the value in circumcision campaigns are those men and women who already have religious or cultural convictions for the practice of circumcision. They would like circumcision to be a free service, performed at hospitals by trained professionals, as opposed to the African bush, performed by amateurs using crude utensils, where men are more likely to suffer complications, including infection, loss of their organ, and even death. People with religious or cultural convictions for circumcision cannot verily declare this to be the case, so they are more than likely to disguise these convictions and desire to have circumcision as a free service by parroting the circumcision/HIV propaganda. "I am glad I am protected," they will say, when they truly mean to say "I cashed in on a free circumcision, thanks to these HIV programs!" "Everybody should be circumcised in order to prevent HIV infection," they will say, when they mean to say "We want all men to be circumcised and must submit to our tribal or religious tradition."THE SOLUTION: More Money, More Propaganda
So ten years and several million dollars later, the great scheme to circumcise Africa in the name of HIV transmission hasn't taken off. Africans simply aren't buying it. Worse than that, the risk compensation nightmare intactivists have warned about from the very beginning is coming true.

Men are walking away with the message that condoms aren't necessary once they're circumcised. This false sense of security makes it difficult for female partners to convince them to wear condoms.

The endorsement of circumcision as HIV prevention is seen as a green light for traditional, rite-of-passage circumcision practices, as well as the forced circumcision of men by men in rival circumcising tribes, resulting in infections, loss of genital organs and death, not to mention an increased risk of HIV transmission due to the usage of dirty, crude equipment.

These "mass circumcision campaigns" are a massive failure. But how are circumcision promotion agencies responding? What is their solution?

More money, more propaganda.

"Insanity is doing the same thing over and over again and expecting different results."

"Demand creation," say the circumcision "experts," is the key.

HIV promoting organizations are observing what's happening, and their solution is to up the ante, use more coercive tactics to get the men to circumcise themselves "voluntarily."

The problem, the reason they aren't seeing men flocking to get circumcised, according to them, is that men simply don't understand what's good for them.

The women don't either.

The solution is to "understand" "why" people aren't buying it, in order to hit the right buttons, come up with the necessary "studies" that quell people's fears, and people will start banging down the doors.

"Demand Creation": What does it mean?
So how are they going to do it?

How are they going to get 5 million men a year to get circumcised?

"Demand creation" are the buzz words among circumcision promoters. But what do these words mean?

To me this can only mean brainwashing and counterproductive propaganda.

When the goal of HIV organizations is no longer to prevent HIV, when the goal is, instead, to circumcise as many men, boys and children as possible, when the goal is to gain the "acceptance" of circumcision, when the goal is to achieve a quota within a certain time frame, then the only outcome of this is can be lies and deception.

In order to achieve "demand creation," one can expect more attacks on African masculinity.

More coercion through sex appeal.

More "studies" exaggerating the "benefits" of circumcision.

More diseases that circumcision is supposed to cure.

With the promotion of male infant circumcision, there will be more "studies" minimizing the risks and harms of circumcision.

Men and women who fully understand the facts, that circumcision is a painful, permanent alteration which, even if the current "research" were correct, could only provide "partial" protection, that circumcision fails and therefore condoms must still be used, do not, cannot possibly see any value in circumcision.

Men fully aware of the facts do not, cannot be convinced to accept this for themselves.

Parents fully aware of the facts, do not, cannot be convinced to accept this for their children.

Therefore the only possible outcome is that, in order to realize quotas and meet deadlines, the facts must be denied, lies must be told, and the truth must be hidden at all costs.

Therefore the only outcome of "demand creation" is that the public will believe that circumcision prevents HIV transmission, that being circumcised means condoms are disposable, that unsafe sex with a man is acceptable as long as he is circumcised.

Therefore the only outcome of "demand creation" is, necessarily, that the HIV epidemic in African countries will be exasperated.

At the expense of the American taxpayer.

At the expense of the truth.

At the expense of scientific credibility.

At the expense of the human dignity of Africans.

At the expense of African lives.

At the expense of basic human rights of minors.

The problem isn't that African men and women "don't understand" and that they need to be "educated," no. The men and women and Africa understand what circumcision and HIV are. They understand that circumcision, even if the "research" were accurate, could only provide "partial protection," that men would still have to wear condoms, and simply aren't interested.

The problem is that the people at HIV organizations, the people at the American CDC, the people at PEPFAR, the people at Bill and Melinda Gates, the people at the WHO have all lost their senses completely.

It is absolute madness that they've all made it the end goal of the HIV movement to circumcise Africa, if not the world. While precious funds could be put to better use, millions are being squandered on promoting a dubious form of HIV prevention which is already superseded by the cheaper, less invasive, more effective modes of prevention which are condoms and education.

This has stopped being about preventing HIV transmission and stopping AIDS; this has become a human experiment in coercion and brainwashing, adding a whole new layer of ethics being violated.

The word "Voluntary" in "Voluntary Male Medical Circumcision" will be devoid of any meaning.

Meanwhile, Back in the US
It is simply mistaken to assume that a mostly circumcised population automatically translates to a lowered HIV transmission rate, as real-world data indicates.

Meanwhile, the CDC has declared that the US is experiencing record highs in STDs. Not to mention that, according to the CIA World Factbook, the US has a higher HIV prevalence rate than 53 countries where circumcision is rare or not practiced.

Why is this important?

Because what "researchers" are trying to achieve in Africa is already reality in the US; 80% of our male population is already circumcised from birth.

Circumcision has been ingrained in American culture for at least a century. Having intact male organs is already stigmatized and openly made fun of on social media, television and film.

Circumcision never prevented HIV or other STDs in America, but somehow, however, people are expected to believe that it is working miracles in Africa.

Can anyone else not see what's happening in Africa for what it is?

An unethical, waste of money?

Millions are being spent to brainwash Africans of a lie the rest of the world doesn't even believe?

Millions are being spent to forcibly cut the genitals of healthy, non-consenting individuals?

Millions are being spent to instill in African men and women a false sense of security?

Which is actually a disservice in the fight against HIV?

Which can be better spent in sex education?

Food?

Water?

Other much needed medicine?

When are world leaders going to see this half-baked effort to circumcise Africa for what it is?

A massive human experiment?

A monstrous hoax?

A practical joke of epic proportions?

When are world leaders going to call to stop taking advantage of Africans?

Isn't it about time to admit that circumcision doesn't work, it never worked, and even if it ever did work, there would already be better ways to prevent HIV?

Isn't it about time to move on and spend those millions of dollars more productively?

Friday, October 21, 2016

This week, medical news outlet MedPage Today published some interesting, if conflicting reports, regarding the acquisition and prevention of STDs.

Just today, they published an article titled "Mass Circumcision Cut HIV Acquisition," where so-called "researchers" try to give the credit of a recent reduction in HIV cases in a select place in Africa, to, you guessed it, circumcision.

The article is, of course, not saying anything that's exactly new. It touts the obligatory reference to the three major trials that make the claim that "circumcision reduces the risk of HIV transmission by 60%." (The figure given in this article is 50%.)

The article's sole objective seems to be to reiterate the claim that circumcision prevents HIV, the only evidence for this is the assertion that circumcision "is working" in Africa, based on mathematical models.

The article admits "[I]t's impossible to tabulate an infection that doesn't take place."

We are told that the "investigators" used three different mathematical models to estimate the impact of the 2015 numbers over the period from 2008 through 2015.

However, flawed models yield flawed results; the model is based on the unsubstantiated hypothesis that male circumcision reduces HIV transmission.

One of the biggest flaws in the trials on which these models are based, is the lack of a scientifically demonstrable causal link.

Without one, the trials, and thus any models based on them, are baseless; researchers must demonstrate how circumcision reduces HIV transmission in the first place, let alone by any percentage; circumcision may not even have anything to do with the recent drop HIV infection.

At best, the models attempt to forcibly graft circumcision into the HIV reduction equation; without a causal link, it must be asked how circumcision fits into the picture at all.

Even taking the results of the questionable trials at face value, even
if circumcision could be said to prevent HIV prevention by the fabled
60% ,
circumcision would be ineffective at preventing HIV and other sexually
transmitted diseases. So ineffective that, in fact, circumcised men and
their partners must be urged to continue to wear condoms.

The recent drop in HIV infections might have more to do with the increased mindfulness of safe sex practices, such as faithfulness and condoms, and nothing to do with circumcision at all.

Reports from other parts of Africa note quite the opposite; an increase in HIV infection, in spite of circumcision indoctrination efforts, can be observed. (See here and here.)

And yet in others, promoting circumcision seems to be giving men a false sense of security, causing them to forgo condoms. (See here, here and here.)

It must be asked; are the "researchers" observing "averted infections" in intact men?

Are they monitoring their behaviors to see how they can prevent HIV transmission without the need for surgery?

Is the goal to prevent HIV transmission?

Or to justify the controversial practice of male circumcision?

Is promoting circumcision actually resulting in the opposite effect of increasing the risk of HIV transmission?

It must be noted that the article opens with the following disclaimer:

Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

...which begs the question of why MedPage Today is even bothering to give this "study" any attention to begin with.

Meanwhile in the US...
While models "prove" circumcision is "preventing" HIV transmission in select parts of Africa, American organizations, such as the CDC and the CIA tells a different story regarding STD transmission in America.

Just a few days ago, the same medical news source published an article regarding a report by the CDC titled "STDs Hit Historic High: CDC."

While the rate of male infant circumcision in the US has dropped to about 56%, according to the very CDC, the prevalence of adult males circumcised at birth is still about 80%.

Circumcision has been near-universal in the US for quite some time now.

Circumcision advocates tout that it "reduces the risk" of countless other STDs, not only HIV, and yet real-world data doesn't correlate with these claims.

According to the CIA World Factbook, the US has a higher HIV prevalence rate than 53 countries where circumcision is rare or not practiced.

In the case of the US, the blame is being put not on the lack of circumcision (80% of adult males are are already circumcised from birth), but on the eroding health systems.

So while near-universal fails to prevent STD transmission, including HIV in the US, somehow we're supposed to believe that it is somehow working miracles in Africa.

Something has got to be wrong with "research" that fails to correlate with reality.

Promoting male circumcision in Africa is a worthless waste of money at best, an unethical disservice which may actually be resulting in an increase of HIV/STD transmission at worst.

Friday, September 30, 2016

The United Nations International Children's Emergency Fund, otherwise known as UNICEF, whose role is supposed to be protector of children's rights is promoting the genital mutilation of male children in the so-called name of HIV prevention.

Currently they're looking for a strategist/consultant to formulate plans to mutilate millions in Africa.

The pretext, of course, is HIV prevention.

However, genital mutilation by any other name would still be genital mutilation.

Wednesday, September 28, 2016

Those who have been keeping their eye on circumcision, circumcision
advocates and their alibis, will no doubt be aware that the diagnosis of
"phimosis" is far too commonly given as a pretext to circumcise an
older child. This is the reason most often cited by parents who claim that circumcision on their child "had to be done." Circumcision is also marketed as prophylaxis for "phimosis"
by those who advocate or have to gain from performing the procedure.

It must be asked, how is it that after thousands of years of evolution, human males evolved to be born with a problematic sexual organ?

Is it that the human penis is inherently problematic?

Or is it that there is no real problem, and opportunistic physicians have been successful in characterizing perfectly normal, healthy stages in male genital development as "problematic," when they're actually not?

American and European Physicians Don't Learn The Same Thing
America and Europe are different in many ways. One of the biggest differences between both continents is circumcision and anatomically correct male genitals. Whereas circumcision, particularly the routine circumcision of infant males, is a common, culturally ingrained practice in the United States, it is rare or virtually not practiced in Europe, except among Jews and Muslims.

Perhaps due to Judeo-Christian roots, people in both continents share a taboo surrounding nakedness, so they are unaware of each others' practices. People in Europe often believe that circumcision is limited to religious groups, such as Judaism and Islam, and generally believe that their American counterparts hold male circumcision in the same regard; people in America believe anyone who's anyone is circumcised. It often comes to a shocking surprise to people in either country, when they find out the truth; Americans are surprised that the rest of the English-speaking world does not circumcise, and Europeans are horrified to find out that in America, male newborns are often circumcised.

It is no surprise, then, that American and European physicians hold different views when it comes to male genitals and circumcision. What they learn in medical school concerning male genital development is vastly different; while European physicians are taught to regard unaltered male genitals as nature made them as healthy and normal, American physicians are taught to look at the same genitals as aliens from another planet. While in Europe, physicians are taught to look at the foreskin as an intrinsic part of the male organ, akin to labia in female organs, in the United States, the physicians are taught to treat the presence of a foreskin as a superfluous growth and a liability. Indeed, some hospitals will list the presence of a foreskin alongside other medical problems.

This picture was taken at an American hospital. Notice that being uncircumcised

is a "problem," along side hearing loss and poor growth and weight gain.

To Europeans, penises in American textbooks may appear strange, as they are depicted as circumcised, as if this is they the human penis appears in nature. To Americans, pictures of penises may be "Ew, gross!" The foreskin, if mentioned at all in American textbooks, is often described as "that loose piece of flesh at the end of a penis, which is removed in circumcision." Whereas European textbooks present the penis as-is and moves on, American textbooks must describe various reasons why circumcision is performed, and why parents ought to make a "decision." Circumcision prevents cancer, STDs, makes it easier to clean, and, it prevents phimosis. What good parent wouldn't want to prevent all these problems in their children?

Of course, when comparing world data, it's not entirely clear that circumcision prevents much. Not a single medical organization recommends male circumcision based on any of the claimed "benefits." Circumcised males are still susceptible to cancer and any STD one can name. The latest canard used to justify male infant circumcision is that it prevents HIV transmission. No, scratch that; it's supposed to "reduce the transmission of HIV transmission by 60%," a claim that doesn't really mean much of anything, as even if it were true, even those who promote circumcision as HIV prevention must stress that circumcised males and their partners must continue to wear condoms. (In other words, male circumcision fails.)

The one valid concern is phimosis, an actual physical condition that is exclusive to males with anatomically correct genitalia.

But what precisely *is* phimosis?

Who gets it?

What causes it?

How common is it in actuality?

When and if it is necessary, what treatment options are available?

When is a situation not "phimosis" but a normal stage in development?

I'm writing this blog post to answer these questions and more.

Here, readers will learn what all physicians should be learning in medical school, but is often omitted in American medical curricula. The sources used for this blog post are cited for reference.

The Facts

What is phimosis?

The word "phimosis" originates from the Greek word phimos (φῑμός)
which means "muzzle". "Phimosis" is a vague term used
to describe any situation where, in intact males, the foreskin cannot be
retracted to reveal the glans, or the head of the penis. The term may
also refer to clitoral phimosis in women, whereby the clitoral hood
cannot be retracted, limiting exposure of the glans clitoridis.

What are the normal stages of development?

At BirthTypically, when a baby boy is born, the
prepuce is long with a narrow tip.(1)(2) Retraction is not possible in
the majority of infants because the narrow tip will not pass over the
glans penis. Moreover, it is normal for the inner mucosal surface of the
prepuce to be fused with the underlying mucosal surface of the glans,
or head of the penis,(1)(2)(4)(5) by
means of a membrane called synechia, also known as the balano-preputial
membrane or balano-preputial lamina,(1) further preventing retraction. This attachment forms early in fetal
development and provides a protective cocoon for the delicate
developing glans.(6) It is normal for the foreskin to be non-retractable in infancy and early childhood.(6)

Retraction of the ForeskinIn normal development, the foreskin
usually separates from the glans and becomes retractable with age.(4) As
the infant matures into a boy and the boy into a man, the tip of the
prepuce becomes wider, and the shaft of the penis grows, making the tip
of the prepuce appear shorter. The membrane that bonds the inner
surface of the prepuce with the glans penis spontaneously disintegrates
and releases the prepuce to separate from the glans. The prepuce
spontaneously becomes retractable.

In order for retraction to occur, the foreskin must have
separated from the glans and the opening of the foreskin must have
widened to allow it to slip back over the glans. Throughout childhood
and adolescence, there is a release of hormones. As hormone levels rise,
the fiber-dense tissue of the prepuce is replaced with a more elastic
tissue. A boy will begin to explore his genitals as he grows, and as time
passes, the elastic tissue will allow the opening of the foreskin to
widen. This can happen at any age but it is not common in young boys.

The amount of time it takes for a boy's
foreskin to become fully retractable varies from boy to boy; this
process can take many years for some boys, and yet minutes for others.
In some boys, the foreskin may not be retractable until after
puberty.(7)(8)(9) This is an entirely normal stage of development and
should not be diagnosed as any kind of "problem."

When Does Retraction Happen?According to the experience of doctors
and researchers in cultures where circumcision is
uncommon, retraction happens at varying ages, and a non-retractable
foreskin rarely requires treatment. Observations from doctors in
Denmark, and Japan and other countries indicate that spontaneous
loosening usually occurs with increasing maturity.(7)(8)(9)(10)(11)(12)

Non-retractability is considered normal for males up to and including adolescence. The
process whereby the foreskin and glans gradually separate may not be
complete until the age of 17.(4) A Danish survey (2005) reported that
average age of first
foreskin retraction is 10.4 years.(13) Marques et al (2005) reported
that 99% of boys can retract their foreskins by age 14.(12)(14)(15)(16)
One may expect 50% of 10-year-old boys; 90% of
16-year-old boys; and 98-99% of 18 year-old males to have a fully
retractable foreskin. Treatment is seldom necessary.

A 1999 study by Cold and Taylor shows that at 6 to 7 years,
approximately 60% of the boys had natural adhesions. At 10-11 years,
close to 50% of the boys still had adhesions. At 14-15, approximately
only 10% of the boys had adhesions. As they approach the age of 17, only
a very small percentage of boys will have adhesions. That means that,
left uncircumcised, most boys will be able to retract their foreskin
before they are 17 years old.

Foreskin Retraction as Observed in Children in Other Countries

Jakob Øster, a Danish physician who conducted school examinations,
reported his findings on the examination of school-boys in Denmark,
where circumcision is rare.(7)
Øster (1968) found that the incidence of fusion of the foreskin with
the glans penis steadily declines with increasing age and foreskin
retractability increases with age.(7)

Kayaba et al. (1996) also investigated the development of foreskin
retraction in boys from age 0 to age 15.5, and they also reported
increasing retractability with increasing age. Kayaba et al. reported
that about only 42% of boys aged 8-10 have fully retractile
foreskin, but the percentage increases to 62.9% in boys aged
11-15.(8) Imamura (1997) reported that 77% of boys aged 11-15 had
retractile foreskin.

Thorvaldsen and Meyhoff (2005) conducted
a
survey of 4000 young men in Denmark. They report that the mean age of
first foreskin retraction is 10.4 years in Denmark.(13) Non-retractile
foreskin is the more common condition until about 10-11 years of age.

Current medical literature indicates that the foreskin is
non-retractable in the majority of males until they begin to approach
puberty. Until a boy begins to reach sexual maturity, non-retractability
of the foreskin is a normal part of growing up.

When is "phimosis" a problem?
Given the empirical facts stated above, it is already mistaken to assume
that just because the foreskin cannot be retracted to reveal the head
of the penis, a male has some sort of pathological condition. As
evidenced by the facts given above, the great majority of male children
who have anatomically correct genitals will have foreskins that cannot
be retracted, and it is a mistake to assume that all children undergo
this transitory "illness" where they can't retract their foreskins, akin
to the mumps, measles or chicken pox. Girls do not begin to menstruate
until the onset of puberty, and they are not considered to be suffering
any sort of medical condition until then.

Non-retractability of the foreskin may pose a problem if it continues
well past puberty. Typically the foreskin has dilated to allow
retraction as a result of the release of hormones. In a small percentage
of males, the production of these hormones is insufficient, and the
foreskin fails to dilate, resulting in a condition known as "preputial stenosis,"
or, a narrow foreskin. This condition may make hygiene and sexual
intercourse difficult, if not impossible, but not always. In older men
that have bad hygiene habits and who smoke regularly, having a
non-retractile foreskin can increase the chances of developing penile
cancer.

There is another reason why the foreskin may not be retractable in a
male, and that is because he has suffered an infection with balanitis xerotica obliterans,
or BXO for short. In this case, the tip of the foreskin is scarred and
indurated, and has the histological features of a pathological
infection. The foreskin of a male who has suffered an infection with BXO
will have developed a fibrotic ring, which makes retraction difficult
or impossible. It is this pathologically induced non-retractability
which can be correctly termed "phimosis." To differentiate normal stages
of development, and even the physiological state of a foreskin which
has failed to dilate as a result of lack of hormones, from
pathologically-caused non-retractability, doctors have invented the term
"true phimosis." It is non-retractability caused by pathological infection with BXO that can be considered an actual problem.

Can phimosis be cured?
It is estimated that 2% of males go their entire lives without their
foreskins ever becoming retractable. How this condition can be treated
will depend on what the actual problem is. The physiological condition
where a foreskin has failed to dilate as the result of a lack of
hormones, otherwise known as "preputial stenosis," tends to respond to
steroid cream therapy, coupled with stretching exercises and/or
stretching
devices.

Non-retractability as a result of a BXO infection, however is different,
as this is caused by a resulting fibrotic ring at the end of the
foreskin, which is scarification that may or may not respond to steroid
cream treatment or stretching exercises. It is non-retractability caused
by BXO infection that can be genuinely considered a problem which may
call for corrective surgery.

It should be noted that non-retractability of the foreskin as a result
of BXO infection occurs in less than 1% of males. Additionally, it
should be noted that even when a case of "true phimosis" may require
surgical correction, it does not always entail a complete removal of the
prepuce. There are procedures that can correct phimosis which can
preserve the foreskin and its functions. Surgical methods range from the
complete removal of the
foreskin (circumcision) to more minor operations to relieve foreskin
tightness, such as a "dorsal slit" (AKA "superincision") a "ventral
slit" (AKA "subterincision") and "preputioplasty."

If treatment should
be necessary, it should not be done until after puberty and the male
can weigh the therapeutic options and give informed consent.(9)

How should a genuine case of phimosis be diagnosed?
In order to correctly determine that there is a real problem occurring
in a male, a learned doctor will begin by ruling a few things out.

If, for example, a child hasn't reached puberty yet, and because
non-retractability is common for this age group, the doctor should
consider that the child may be experiencing normal stages of
development.

If, for example, a child hasn't reached puberty yet, but he was able retract his foreskin previously, it may be probable that the child may have experienced an infection with BXO.

If, for example, an adult male who has already gone through puberty
still has a non-retractile foreskin, the doctor needs to determine if
this is a physiological problem caused by a lack of hormones (preputial
stenosis), or if it is a pathological problem as a result of infection
with BXO (AKA "true phimosis").

Because non-retractibility of the foreskin can be both a normal stage of development, and
a pathological problem, it can be very easy for doctors to make an
inadvertent, or even deliberate misdiagnosis. Particularly in countries
like the United States, where circumcision is a perceived norm, and
doctors may not be educated in the differences between normal stages of
development and phimosis as a pathological condition, it can be very
easy for doctors to say that a child is suffering a condition that may
require surgical correction, where in fact, there is actually none.

For a correct diagnosis, a doctor who is knowledgeable about the
difference between normal stages of development and non-retractability
caused by BXO infection will correctly have the male analyzed for signs
of lesions of BXO. Then, and only then, can a doctor properly make the
diagnosis that a male child is suffering a medical problem, and that the
child may need surgery to correct the problem.

Because non-retractability in adult males is rare, and "true phimosis"
(pathologically induced non-retractability) even more rare, there is a
high probability that a diagnosis for "phimosis" is actually false,
especially in children, where non-retractability of the foreskin is a
part of normal development.

Iatrogenically Induced Problems
Problems with the retraction of the
foreskin may either be the result of a lack of hormones, the result of
an infection with BXO, or, they could be iatrogenically induced. (E.g.
actually caused by the doctor himself.)

It has been widely recognized by the
medical profession
for most of the 20th century that normal male infants have foreskins
which are incompletely separated from the epithelium of the glans.(17)
The foreskin cannot be retracted without tearing the fusion and
adhesions which are commonly present between the inner foreskin and the
glans penis in normal
stages of development.

In English-language medicine, there is
an absence of proper knowledge of the foreskin and its development in
the medical curriculum. According
to McGregor et al (2005), physicians often have
difficulties distinguishing between this normal, natural state of the
penis in neonates and pre-pubecent boys and pathological
phimosis caused by BXO.(17)(18) Spilsbury et al (2003) suggest that
doctors may be likely to confuse the aforementioned conditions with
pathological phimosis.(19)

Unaware of the harmless nature of the
normal, natural
state of the penis in neonates, and the presence of
adhesions in infants and pre-pubecent boys, and unaware that this can be
damaging, doctors have been known to forcibly attempt to retract
the foreskin in healthy, developing children, just to see if it
retracts, tearing natural
adhesions and/or ripping the foreskin in the process. Furthermore, they
have been known to erroneously instruct parents that a child's foreskin
needs to be retracted in order to "clean under it," arguing that they
will develop infections otherwise.(20)

Premature, forcible retraction of the foreskin is an extremely painful,
serious, and potentially permanent injury(17). It can damage the glans
and mucous inner tissue of the foreskin. Forcibly retracting a child
could result in iatrogenically induced phimosis, where the raw, open
wounds of ripped adhesions could heal and fuse together, or where a
forcibly dilated foreskin could develop scarification, resulting in a
fibrotic ring similar to the one caused by BXO infection. Additionally,
this can result in a complication known as "paraphimosis," where the
narrow foreskin strangles the penis trapped behind an enlarged glans,
thereby necessitating surgical intervention.

It must be noted here that these problems rarely present themselves in
countries where circumcision is rare or not practiced. There is simply
no epidemic of foreskin problems in countries where male children aren't
circumcised. These problems tend to suspiciously present themselves in
countries where circumcision is common, and diagnosed by doctors who
happen to specialize in child circumcision. Children may have been
circumcised to correct "problems" that either never existed, or whom
were given their problems by ignorant doctors to begin with.

It is harmful and misleading to tell parents that a child's foreskin
must be forcibly retracted. In children whose foreskins are still
adhered to the glans, or where the foreskin has not dilated to allow the
glans, this can be a harrowing experience. Forcibly retracting a
child's foreskin "to clean under it" is the equivalent of cleaning out a
girl's vagina with a pipe cleaner. Surely, a doctor who would instruct
parents to clean out their child's vagina would be dismissed as a
lunatic. Medical associations advise not to forcibly retract the foreskin
of an infant, as this interferes with normal penile development, and may
result in scarring or injury.(21)(22).

Camille et al (2002), in their guidance for parents, state that "[t]he
foreskin should never be forcibly retracted, as this can cause pain and
bleeding and may result in scarring and trouble with natural
retraction."(23)

Simpson & Barraclough (1998) state that "[n]o attempt should be made
to retract a foreskin in a child unless significant separation of the
subpreputial adhesions has occurred. Failure to observe this basic rule
may result in tearing with subsequent fibrosis and consequent
[iatrogenically induced] phimosis. ..."(24)

The American Academy of Pediatrics cautions parents not to retract their
son's foreskin, but suggest that once he reaches puberty, he should
retract and gently wash with soap and water.(25) The Royal Australasian
College of Physician as well as the Canadian Paediatric Society
emphasize that the infant foreskin should be left alone and requires no
special care.(26)

Summary
The facts, which are well-documented in medical literature, speak for themselves.

A foreskin that is adhered to the glans and/or will not retract is a
normal stage of development in all healthy male children in infancy. The
belief that a foreskin that is "tight" and will not retract is a
problem in male infants implies that all human male children are born
with some kind of birth defect, congenital
deformity or genetic anomaly akin to a 6th finger or a cleft.

In the great majority of males, the foreskin separates from the glans
and becomes retractable as they approach puberty, without the aid of
medical or surgical intervention.

A foreskin that will not retract in older males is rare, and may or may
not be a pathological problem. In order to determine the cause of a
non-retractile foreskin, a knowledgeable doctor who understands
anatomically correct male genitals, the normal stages of development of
healthy males, and true pathological problems of male genitalia, must
run the correct analyses in order to detect the presence or absence of
pathological lesions; then, and only then, can the doctor determine
whether the problem can be remedied with conventional medicine or by
means of surgical correction.

Even when a genuine case of phimosis that necessitates surgical
intervention presents itself, circumcision, or the full excision of the
foreskin is not always called for; there are surgical interventions
which will correct phimosis while preserving the foreskin and its
functions.

Intervention to hasten the retraction of the foreskin in otherwise
healthy, prepubescent males may actually cause iatrogenically induced
problems. The forced retraction of the foreskin may itself cause
non-retractability. Forcibly dilating the foreskin causes scar tissue to
form, which may result in a fibrotic ring at the end of the foreskin.
Breaking the natural adhesions which occur between the glans and the
foreskin during normal stages of development may cause new adhesions to
form between the glans and the foreskin, becoming fused as the raw
wounds of the broken adhesions heal together. Forcibly pulling back
naturally narrow foreskin over the glans in otherwise healthy children
may result in paraphimosis, where the narrow foreskin catches behind the
glans, preventing the foreskin from returning to its neutral position
covering the glans, ironically necessitating the need for surgical
intervention.

Conclusion
It is a shame that there is a gap in medical knowledge between the United States and other English-speaking countries. The information presented here is well-documented knowledge that all doctors need to know. This is the information that a doctor needs to be giving to parents of a male child. Anything other than this is misinformation or an outright lie.

American medical curricula is either omitting information, teaching outdated information, if not outright teaching misinformation. Efforts need to be made to bring English-language curriculum on the
foreskin, the natural stages of development and genital pathology up to
date. Doctors need to educate themselves and stop dispensing erroneous
and dangerous advice to parents. They need to learn to differentiate
between the normal stages of development in human males, and actual
pathological phimosis.

Doctors who diagnose
"phimosis" in a perfectly healthy child are either uneducated when it
comes to the foreskin and natural stages of development, or may in fact
be committing medical fraud, deliberately inventing a misdiagnosis in
order to justify surgery in a healthy, non-consenting minor, and/or
collecting medicaid funds intended for actually medically necessary
surgery.

Until American medicine undergoes this long-needed overhaul, long-term visitors to the United States ought to be warned that doctors in America are often inadvertently, or quite deliberately misinformed about anatomically correct male genital anatomy, and that taking their child to an American-trained doctor could be hazardous to their child's health.

7. Øster J. Further fate of the foreskin: Incidence of preputial
adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child
(published by the British Medical Association), April 1968. p. 200-202.

21. "Care of the Uncircumcised Penis". Guide for parents. American
Academy of Pediatrics. September 2007.
http://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Care-for-an-Uncircumcised-Penis.aspx.

22. "Caring for an uncircumcised penis". Information for parents.
Canadian Paediatric Society. July 2012.
http://www.caringforkids.cps.ca/handouts/circumcision.